Diagnostics - Scan Lower Motion Testing: Sidebending and Rotation from the Backward Bent Position Diagnosis: The positional diagnosis is FRSright, and the motion restriction is ERSleft.
If a left facet does not close normally, but the right does close normally, right sidebending will be possible but left sidebending will be restricted in the backward bent position. In the cervical spine during flexion/extension, sidebending and rotation are coupled movements in the same direction. Therefore, rotation will also be affected by facet joint dysfunction. If the left facet does not close normally, we would expect to encounter abnormal resistance with left to right translation in the backward bent position. The segment is said to be restricted in extension, rotation left, and sidebending left. The positional diagnosis is FRSright, and the motion restriction is ERSleft.
For example, while monitoring a typical cervical segment at the articular pillars, you extend the cervical segment by gently lifting it. You notice that the finger you have placed upon the right articular pillar moves slightly inferior and posterior, but the finger monitoring the left articular pillar does not move (or if it does move, it moves less than the right side). You also notice that you encounter abnormal resistance when you translate the segment from left to right. When you flex the patients cervical spine, you note that both fingers monitoring the articular pillars move symmetrically, slightly anterior and superior, and that you encounter normal translational resistance in both directions. We know that in flexion the facets are supposed to open, and that in extension the facets are supposed to close.
In flexion, both facets are fully opened. The vertebra faces directly forward because there is no rotational component associated with the forward bending.
However, in extension, the right articular pillar moves posterior and inferior to the left articular pillar, indicating that the left facet has not fully closed.
Because the left facet has not closed properly, we see right rotation (with right sidebending) of the vertebra, with the left facet functioning as a pivot point.
We conclude that the segment is restricted in extension, rotation left, sidebending left (ERSleft). The positional diagnosis is FRSright. Visualize this type of dysfunction from a -- .
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